Clinical establishment act – a game theoretic perspective

Abstract

The healthcare system in India is largely privatized, and there have been innumerable incidents of unethical practices within it. Despite the unprecedented growth in the private sector, it is mostly unregulated. The quality of healthcare services is unacceptable in quite a few of these hospitals, to the extent that it becomes difficult to prevent medical negligence. Many of these private institutions have been operating without any registration, and there has hardly ever been an inspection for the same. The Medical Councils of various states have completely failed to act against doctors, and were poorly regulated. Also, private hospitals have mostly refused the norms laid by the Centre and State-run health schemes, as has been evidenced from the various cases where rules have been flouted while charging BPL patients. With growing reports of such practices, in 1995, the Supreme Court made a landmark judgment saying that the Consumer Protection Act was applicable to the medical profession, which gave rise to the need for regulating the clinical establishments and the quality of services provided by them. Another major concern is the lack of complete information regarding the available resources of healthcare with the policy makers, as there is no system of information collection from private health establishments. Thus, the need for having an Act for regulating Clinical Establishments got reinforced to ensure appropriate policy formulation around healthcare. The Clinical Establishments Act has many benefits which address the concerns mentioned above, however, it is receiving severe criticism from multiple stakeholders. This paper tries to highlight the benefits and limitations of the Act, and the game theory behind the claims.